Hormonal contraception :.

[Warrior]

Hormonal contraception in Chinese men: variations in suppression of spermatogenesis with injectable testosterone undecanoate and levonorgestrel implants.

AIM: To explore the causes of the difference in spermatogenic suppression between responders and non-responders in Chinese men treated with levonorgestrel (LNG) implants plus testosterone undecanoate (TU) injectable. METHODS: The 16 Chinese volunteers treated were divided into two groups in regard to the sperm count during the treatment period, 7 men in the responder group (Group R), including 6 azoospermia and one severe oligozoospermia, and the remaining 9 in the non-responder group (Group N), including 4 oligozoospermia and 5 with sperm counts greater than 20 x 10(6)/mL. The differences in serum profiles of FSH, LH, T, LNG and T/LH ratio were compared between the two groups and the correlation between the seminal fluid parameters and serum reproductive hormones was analyzed. RESULTS: The serum FSH level was lower in Group R than that in Group N (P<0.05), while the serum LH and LNG levels were higher in Group R than those in Group N (P<0.05). The sperm density (P<0.01, r=0.235), motility(P<0.01, r=0.326) and vitality (P<0.01, r=0.219) showed significantly positive correlation with the serum FSH level. CONCLUSION: The blood LNG and T levels, the degree of FSH inhibition and/or the sensitivity of the pituitary-testis axis to exogenous steroids, as well as the individual spermatogenetic potential and the functional status of the Leydig cells may be factors bringing about individual differences in spermatogenic suppression in Chinese men treated with LNG and TU.

PMID: 15064833 [PubMed - indexed for MEDLINE]

TESTOSTERONE GEL COMBINED WITH DEPOMEDROXYPROGESTERONE ACETATE IS AN EFFECTIVE MALE HORMONAL CONTRACEPTIVE REGIMEN AND IS NOT ENHANCED BY THE ADDITION OF A GnRH ANTAGONIST.

Introduction: Exogenous androgens + progestins can be used to suppress spermatogenesis resulting in effective male hormonal contraception; however, induction of azoospermia can require 3-6 months and these methods require injectable or implantable androgens. We hypothesized that testosterone (T) transdermal gel (T gel) could be combined with a depot formulation of the progestin, depomedroxyprogesterone acetate (DMPA), with or without the potent gonadotropin-releasing hormone (GnRH) antagonist, acyline to conveniently, rapidly and reversibly suppress spermatogenesis. Objectives: 1) Determine the rate of severe oligospermia (</=1 million sperm/ml) using T gel + DMPA. 2) Determine whether the addition of acyline to T gel+DMPA during the first 12 weeks of the regimen would accelerate and improve suppression of spermatogenesis. Methods: Forty-four healthy men, ages 18-55 were randomized to T gel (100 mg daily)+DMPA (300 mg/3 months) or Acyline (300mcg/kg/2 weeks x 12 weeks) +Tgel+DMPA. Thirty-eight men completed the 24-week treatment protocol. Results: All men had dramatic suppression of spermatogenesis; 90% of subjects became severely oligospermic, a rate comparable to implantable and injectable T+progestin combinations. The addition of acyline did not significantly accelerate spermatogenic suppression or improve rates of severe oligospermia. There were no serious adverse events and there were minimal changes in weight, serum lipids and PSA. Conclusions: 1) The combination of T gel + DMPA is a promising new regimen male contraception. 2) The addition of the GnRH antagonist acyline, as part of an induction phase in a male contraception regimen, has limited clinical utility. Additional studies using T gel for male contraception are warranted.

PMID: 16940442 [PubMed - as supplied by publisher]

Drug insight: Recent advances in male hormonal contraception.

As there are limitations to current methods of male contraception, research has been undertaken to develop hormonal contraceptives for men, analogous to the methods for women based on estrogen and progestogens. When testosterone is administered to a man, it functions as a contraceptive by suppressing the secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) from the pituitary gland. Since these hormones are the main stimulatory signals for spermatogenesis, low levels of LH and FSH markedly impair sperm production. After 3-4 months of testosterone treatment, 60-70% of men no longer have sperm in their ejaculate, and most other men exhibit markedly diminished sperm counts. Male hormonal contraception is well tolerated, free of serious adverse side effects, and 95% effective in the prevention of pregnancy. Importantly, male hormonal contraception is reversible, with sperm counts usually recovering within 4 months of the discontinuation of hormone treatment. Because exogenous testosterone administration alone does not completely suppress sperm production in all men, researchers have combined testosterone with second agents, such as progestogens or gonadotropin-releasing-hormone antagonists, to further suppress secretion of LH and FSH and improve suppression of spermatogenesis. Recent trials have used combinations of long-acting injectable or implantable forms of testosterone with progestogens, which can be administered orally, by injection or by a long-acting implant. Such combinations suppress spermatogenesis to zero without severe side effects in 80-90% of men, with near-complete suppression in the remainder of individuals. One of these testosterone and progestogen combination regimens might soon bring the promise of male hormonal contraception to fruition.

PMID: 16932251 [PubMed - in process]

Warrior's take away messages (as if speaking in the third-person isn't cool!):

Using a progestenic steroids, like trenbolone or nandrolone with testosterone, will make a cycle more likely to bring sperm counts to zero.

FSH and LH suppression is the root of spermatogenic suppression - not the androgens themselves.

It is highly likely that spermatogenic suppression will occur, and it can take up to 6 months to reverse.

[napoleon]

Cool Post bro!

Great read

[shifty_git]

Very Interesting Read!

Does this mean we are all ganna get free roids from the family planning clinic?? ha ha

At least if thngs go this way we're never gann be able to use the excuse - will i forgot to take my pill! cause i know thats never ganna happen! lol